Recurrent Toxic Epidermal Necrolysis Syndrome: A Report of T
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Stevens–Johnson syndrome and toxic epidermal necrolysis or Brocq–Lyell syndrome are dermatoses triggered principally by drugs. Cases reported as recurrent have been attributed to infectious or environmental factors. However, most cases in the pediatric population are not related to recurrences secondary to drug intake. Demonstrating the causal medication with certainty is complex.
We present two cases. The first was a man with TEN secondary to naproxen intake in whom sulfonamides had previously triggered the same syndrome. The second was a woman with a history of SJS after ingesting sulfonamides and who presented, in her most recent hospitalization, with TEN triggered by alternative medicines.

The patient was male, 81 years old, and had a 30-year history of alcoholism. He presented with overlapping SJS/TEN syndrome in 2007 secondary to ingestion of trimethoprim/sulfamethoxazole indicated for a urinary tract infection. In that instance, he required hospitalization for 1 week and was discharged to his home. This time, 6 years later, he presented with the same syndrome 2 days after ingestion of oral naproxen tablets 250 mg twice a day indicated as an analgesic.
He was admitted to our hospital unit with dermatosis affecting 20 % of his body surface manifesting as flaccid blisters on an erythematous base, a positive Nikolsky sign, conjunctivitis, and ulcers in the oral mucosa. He had a Score of Toxic Epidermal Necrosis score of 4 points. He presented with signs and symptoms of sepsis, hyperglycemia, and elevated ureic nitrogen. He was treated with intravenous immunoglobulin (400 mg/kg/day completing a 5-day course); however, on hospital day 15, he developed multiple organ failure and unfortunately died....